Miocrdiopatía "Takotsubo"

La miocardiopatia takotsubo es un síndrome cardiaco reportado recientemente en Japón por Sato 1990, que se caracteriza por disfunción ventricular izquierda transitoria, dolor precordial opresivo, cambios electrocardiográficos de tipo isquémico, discreta o nula liberación de marcadores de necrosis miocardio. Este síndrome usualmente se presenta después de un severo estrés físico o emocional, y se observa predominantemente en personas del sexo femenino

Spatial variance in the 12-lead ECG and mechanical dyssynchrony

Introduction: Electrical transmission disorders have a deleterious effect on cardiac depolarization, resulting in a disorganized ventricular contraction that reduces global mechanical efficiency; this mechanical dyssynchrony can be corrected by cardiac resynchronization therapy. However, despite adjustments in the electrical criteria selection of QRS for the recognition of mechanical dyssynchrony, a significant proportion of patients do not currently respond to this therapy. Purpose: To find if a new predictor of dyssynchrony, the electrocardiogram spatial variance, is a better marker of mechanical dyssynchrony than QRS duration. Methods: Forty-seven electrocardiograms and 47 strain (2D speckle tracking) echocardiograms were prospectively collected simultaneously in consecutive, non-selected patients; the left ventricular mechanical dispersion was measured in all the cases. The electrocardiographic analysis of variance was made with a digital superposition of the electrocardiographic leads and generates different indexes of variance of both QRS complex and repolarization phase. Results: ROC analysis probed that the best area under the curve (AUC) value correlated with left ventricular mechanical dispersion and was obtained combining several spatial variance markers (considering depolarization and repolarization spatial variance together; AUC = 0.97); the same analysis using the QRS duration versus mechanical dispersion showed a significantly lower AUC value (AUC = 0.64). Conclusion: Spatial variance combining depolarization and repolarization markers is a superior predictor of left ventricular mechanical dispersion than QRS duration.Fil: Bonomini, Maria Paula. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Saavedra 15. Instituto Argentino de Matemática Alberto Calderón; ArgentinaFil: Villaroel Abrego, Hugo. Universidad del Salvador. Facultad de Medicina; ArgentinaFil: Garillo, Raúl. Pontificia Universidad Católica Argentina "Santa María de los Buenos Aires"; Argentin